The San Joaquin Valley Community Clinical Program (SJV CCOP, CCOP) is a consortium of eight Central California hospitals and 49 physicians of diverse specializations. This is the only rural CCOP in the Southwestern United States. It benefits over one million people in 205 cities and towns, scattered throughout a six-county area covering 17,000 mi2. The Valley's population is comprised of 70 distinct ethnic groups, making it one of the most ethnically diverse areas in the world and an excellent location for the development of cancer control studies. Overall these minorities comprise 43% of the population, with the single largest group being hispanic (25%). The Program's objectives are: (1) to continue providing state-of-the-art treatment and cancer control research to patients in their own communities while enabling physicians to participate in NCI-approved clinical trials. (2) to maintain the rural population's only local access to clinical trials, while preserving the opportunity to investigate the impact of cancer therapy and control advances in community medical practices. (3) to provide patients with access to cancer control and treatment clinical trials at all points of entry into the medical system. (4) to continue accrual of minority groups to clinical trials, and increase their participation to levels at least equivalent to minority cancer incidence reflected in the Valley's population. (5) to provide structure and mechanisms for accelerated transfer of knowledge gained through clinical trials to the medical community. The SJV CCOP is governed by an Executive Board and written bylaws. It is comprised of a Principal Investigator, Associate Principal Investigator, seven Co-Principal Investigators, and seven standing committees. The Program is affiliated with five research bases which provide access to treatment and cancer control protocols: the National Surgical Adjuvant Breast and Bowel Project (NSABP), the Southwestern Oncology Group (SWOG), the Radiation Therapy Oncology Group (RTOG), and the University of Rochester Cancer Center (URCC). The CCOP has a headquarters office at Fresno Community Hospital, which houses the Program Coordinator, Assistant to the Coordinator, and one data manager for the central area. Additional offices are located North (Saint Agnes Medical Center) and South (Kaweah Delta District Hospital) of headquarters. Each of these offices are staffed by a data manager to service area physicians. All of the offices are tied together by the CCOP's computer system to allow continuity of services.